Provider Demographics
NPI:1528572070
Name:SWARTZ, SANDRA ARRETHA (PCA)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:ARRETHA
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 692
Mailing Address - Street 2:
Mailing Address - City:RAINELLE
Mailing Address - State:WV
Mailing Address - Zip Code:25962
Mailing Address - Country:US
Mailing Address - Phone:304-438-5724
Mailing Address - Fax:
Practice Address - Street 1:164 FAYETTE AVENUE
Practice Address - Street 2:
Practice Address - City:RAINELLE
Practice Address - State:WV
Practice Address - Zip Code:25962
Practice Address - Country:US
Practice Address - Phone:304-438-5724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant